26 December 2010

Peanut Allergy Treatment #3 and #4

Appointment #3 December 16th

I was unable to take Alexander to his appointment so I enlisted the help of his grandmother Judy. She was great. Judy had to pick up Alexander (and his brother Dylan) at school and take them to the peanut appointment. All went smoothly yet to my surprise Alexander's came home with a "peanut pill".                                                                                     
No more peanut and grape juice cocktail. No more refrigeration. 
The pill turned out to be a much easier way to take his dose although according to Xander "the pill is a pain". 
The peanut capsule is teeny tiny
The peanut protein has to be dug out of the capsule with a toothpick to get every grain. Needless to say my son is looking forward to the capusule size increasing so he can eliminate digging for the peanut dust with a toothpick. 
Swallowing of the capsule is not allowed. 
I am not sure why. 

For his first at home dose Alexander mixed the peanut powder into yogurt. This worked "ok" but not great. Eventually he chose to mix the peanut flour into liquid. 

The instructions he received from the nurse were explicit when it came to mixing the peanut flour from the pill into liquids. His brother Dylan was quick to remind him of this fact.
The rule: Mix the entire capsule contents into a glass of liquid then swirl the powder to mix well. Drink. Next to be sure no peanut protein or traces are stuck on the sides of the glass, add more liquid to the same glass then swirl to mix and drink.

The remainder of the week proceeded normally and Alexander was very diligent to follow the dosing instructions and timing exactly. Another successful week!

Appointment #4 December 23rd

We arrive at the office and follow the same routine as outlined in an earlier post. 
Believe me I am so thankful that this process is becoming routine.
What a relief and a blessing the peanut desensitizing is going well thus far.

Alexander's dose is increased to 100 mg of peanut flour given twice daily as shown in our dosing instruction sheet picture below. 
Since it would be so much easier if the peanut pill could be swallowed I asked the Physician's Assistant why the dosing instructions did not allow swallowing of the pill. It turns out that no research has been done to determine if this capsule itself would be fully digested. If not then the peanut flour would not be fully absorbed either. 
Ok. Good rule. Makes sense. 
We wait the customary 1 hour after the dose is administered - no reaction and we are on our way home.

At home Alexander embarks on the project of digging the peanut flour out of the tiny capsule. 

This time the new increased dose of 100 mg is contained in what seems to Xander to be the same teeny size capsule. (to my eye it is slightly bigger).
This time the toothpick method of extracting the last bit of powder is traded for a new "improved" digging device pictured below. (I have cropped the photo for an up close look)
To Xander's delight indeed the new tool proves handy. 

The dosing method is a follows.
1) The capsule is opened and the peanut flour is added to a glass containing some liquid. Alexander uses gatorade or juice
2) Xander drinks the solution immediately. 
He does not like the peanut taste but the tried and true method of holding ones nose works like a charm. 
4) Again more gatorade is poured into the same glass and swirled around to ensure every single molecule of peanut flour is mixed into the liquid. 
5) Down the hatch!  
6) The current dose is successfully taken.  

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